ACCOUNTING INFORMATION SYSTEM AND PREVENTION OF FRAUDULENT DRUG SUPPLY AT THE KARDINAH TEGAL GENERAL HOSPITAL

This study aims to determine the application of accounting information systems, internal control, factors causing stock outs, and prevention of fraud in drug supplies at Kardinah Tegal Hospital. Data collection methods used in this study were observation, interviews, and documentation. The data used consists of primary data and secondary data. The data analysis technique used is descriptive qualitative method. The results of the study explain that the application of the accounting information system for drug supplies as a whole is good, including: 1) Kardinah Hospital Tegal has operated a Pharmacy Hospital Management Information System (SIMRS) as an information system and efficient management of medicines starting from planning, procurement, receipt , distribution, and administration of invoice payments, 2) There are SOPs related to the logistics management of pharmaceutical supplies, out-of-stock handling procedures that aim to improve optimal prescription services but in practice there are inconsistencies with SOPs so it is recommended for SOP revisions, 3) The current internal control has been appropriate and has implemented internal control standards according to the Committee of Sponsoring Organization (COSO), and 4) The factors causing the scarcity of medicine supplies include vacancies at distributors, delays in delivery of goods, late payments to partners, and na available is not sufficient. To prevent fraud, Kardinah Tegal Hospital must implement healthy practices to minimize fraud, both internally and externally.


INTRODUCTION
The industrial sector is divided into three sectors, namely the critical sector, the essential sector, and the non-essential sector. The critical sector is the most important business environment, while the essential sector is a very necessary or basic business environment, if the non-essential sector is an unnecessary or non-essential business environment. Industrial sectors included in critical sectors such as health, disaster management, logistics, transportation, distribution for basic needs and others, while those included in essential sectors such as communication and information technology (IT) workers, finance and banking, capital markets and others, meanwhile if nonessential sectors such as cafes, restaurants, shopping centers (malls) and others (Rizal et al., 2021). One of the government institutions included in the critical sector is a hospital that is engaged in public services by offering health services whose products are in the form of medical services.
In the current era of globalization, technology is progressing very rapidly, all companies or entities seek to improve and improve quality as much as possible (Sulisnayanti & Wahyuni, 2017). Likewise in the field of health services, namely hospitals, drug supplies must be managed optimally so as to avoid shortages (out of stock) or fraud.
To be able to meet the care needs of patients, the hospital has provided various medical service facilities, one of which is pharmacy installation services. The pharmacy installation is the most important part in the hospital to provide and store medicines and medical consumables. However, there are times when drug supplies run out of stock (stock out), drug vacancies or out of stock (stock out) or stockpiles (stagnant) have a medical and economic impact, things like this require effective and efficient drug management efforts. Hali et al., 2021).
To facilitate supervision, a system is needed that can monitor any changes in drug supply and can detect fraud as early as possible. This system must also be able to control the inventory so that inventory management can be disciplined. One of the important systems needed is an accounting information system (AIS) which is aligned according to the needs and conditions. Internal control of merchandise inventory and accounting information systems are very important in achieving company efficiency and Business Management and Accounting_Volume 2 Issue 1 (2022) "Strengthening Youth Potential for Sustainable Innovation" 34 effectiveness so that fraud prevention can be carried out as early as possible (Mufidah, 2017).
The system used at Kardinah Tegal Hospital is a hospital management information system (SIMRS). Kardinah Tegal Hospital Pharmacy itself is the only work unit in the distribution of medicines to patients. In managing the drug supply, it is directly connected to the main hospital system, namely SIMRS which includes drug orders, prescription services, and stock taking.
Inventories of drugs in hospitals are assumed to be finished goods inventory, where drugs purchased from pharmaceutical companies are then distributed or sold to patients. Drug supplies with a large enough scale are very easy to cause fraud, for that it needs to be monitored and protected. Fraud can be interpreted as an act of fraud that is carried out intentionally by violating several regulations that have been set by the parties involved authorized in a company in order to obtain personal gain and harm other parties (Mardianto & Tiono, 2019).
To be able to face competition, it is necessary to be careful and careful in planning so as to be able to calculate the ideal purchase number so that there is no excess or shortage of inventory and does not interfere with the smooth operations of the company and can reduce costs (Wijaya et al., 2016).
This study aims to explain how the procedures and accounting information systems for drug supplies, how internal control of drug supplies, what factors cause a shortage of medicine supplies and how to prevent fraudulent drug supplies at Kardinah Hospital Tegal. This study contributes to references for improving SOPs for drug supplies, identification of factors causing shortages of drug supplies, implementation of internal controls to prevent fraud.

LITERATURE REVIEW
Sulisnayanti & Wahyuni (2017) explain that the system is a series of several interrelated and interacting components to achieve a goal. Data itself is a fact that is collected, stored, and processed by a system. Information is data that has been processed and processed to give meaning and to improve the process of making organizational decisions. Accounting is a process of identifying, collecting, and storing data and the process of developing, measuring and communicating information.
To facilitate supervision, a system is needed that can monitor any changes in drug supply and can detect fraud as early as possible. This system must also be able to control inventory so that inventory management can be disciplined. One of the important systems needed is an accounting information system (AIS) which is aligned according to the needs and conditions. Internal control of merchandise inventory and accounting information systems are very important in achieving company efficiency and effectiveness so that fraud prevention can be carried out as early as possible (Mufidah, 2017). In the activity of managing assets, a company requires an accounting information system so that existing assets can be maintained properly. An accounting information system is a collection of resources, such as people and equipment, designed to process data into information. So that the resulting information can be communicated to many decision makers. This system makes it happen manually and computerized (Nurhasanah et al., 2019).
The system used at Kardinah Tegal Hospital is a hospital management information system (SIMRS). This system is a consolidated information system to handle all management flows starting from diagnosis and treatment services to patients, medical records, pharmacies, pharmacy logistics warehouses, SIMRS also handles computerized systems both hardware and software and management control in the form of network coordination and administrative procedures. to obtain accurate and reliable information. Kardinah Tegal Hospital Pharmacy itself is the only work unit in the distribution of medicines to patients. In managing the drug supply, it is directly connected to the main hospital system, namely SIMRS which includes drug orders, prescription services, and stock taking. The existence of a health information system is quite useful in the process of data processing activities, because most of the work is done on computers that have been programmed with various programs that are handled by an application (Setyawan D, 2016).
Inventories of drugs in hospitals are assumed to be finished goods inventory, where drugs purchased from pharmaceutical companies are then distributed or sold to patients. Drug supplies with a large enough scale are very easy to cause fraud, for that it needs to be monitored and protected. Fraud can be interpreted as an act of fraud that is carried out intentionally by violating several regulations that have been set by the competent parties in a company in order to obtain personal gain and harm other parties (Mardianto & Tiono, 2019). The continuity of the company can be hampered or may stop if the act of fraud or fraud is left unattended without any precautions and efforts are made to uncover the existence of these actions (Sanusi et al., 2020). Fraud can also be seen as a form of fraud, concealment of the truth with the aim of deception or manipulation to the detriment of the other party. The causes of fraud according to Donald R Cressey with the fraud triangle theory are pressure, opportunity, and justification. Fraud is an illegal act carried out by one person or Business Management and Accounting_Volume 2 Issue 1 (2022) "Strengthening Youth Potential for Sustainable Innovation" 35 group of people intentionally and planned which causes that person or group to benefit and harm other people or groups (Rika et al., 2020). Acts of fraud itself can be prevented by maximizing internal control. In addition, fraud can be prevented on the basis of the awareness of each individual. Handling carried out to prevent and detect fraud or fraud which is often likened to a disease needs to be improved with various efforts such as providing input, suggestions, proposals or anticipatory actions that need to be socialized regularly, so the socialization carried out must be more adapted to the perpetrators of fraud (fraud) themselves, because in general fraud is carried out by those who have positions or power, have expertise, and are highly educated (Aksa, 2018). Even though the system has been used, it does not rule out the possibility of running out of stock so it is necessary to identify the causative factor so that it can be overcome. Out of stock will have an impact on service delays, while the occurrence of over stock will result in swelling of inventory costs. When inventory exceeds the company's needs, it can result in increased maintenance and storage costs while increasing the likelihood of goods becoming unusable or damaged. On the other hand, if the company tries to minimize inventory, the company will face the problem of scarcity or stock out which will hinder the continuity or smooth running of a company's business activities (Lahu et al., 2017).

METHOD
The object of this research is the pharmacy installation of Kardinah Tegal Hospital which is located on Jalan AIP KS. Tubun No. 2, Kejambon Village, East Tegal District, Tegal City, Central Java. The type of research used is qualitative descriptive research. Types and Sources of Data are Primary Data: primary data taken is the result of interviews with related parties regarding the accounting information system for drug supplies and Secondary Data: secondary data used are general descriptions, job descriptions, drug inventory procedures, internal policies.
Technical data collection is direct observation to the object of research, interviews with the leadership and employees of pharmacy installations and documentation.
The data analysis carried out is a comparative analysis, namely observing SOPs for procedures and drug supply systems, comparing SOPs with healthy practices, internal control of drug supplies by comparing with COSO, identifying factors for the occurrence of shortages of medicines supplies, and preventing fraud medicine supplies.

Analysis of Drug Inventory Procedures and Information Systems
Interpreting drug inventory accounting information systems and procedures and comparing written SOPs with practice (1) (2022) The following is the data from the review of the accounting information system for the supply of medicines at the Kardinah Hospital, Tegal based on the Standard Operating Procedures (SOP) that apply in practice:  (2022) Based on table 1 data, it is known that there are four procedures including planning procedures, procurement procedures, receipt procedures, and invoice paying administrative procedures that are not in accordance with the applicable SOP. Meanwhile, in the storage procedure, the distribution procedure is in accordance with the applicable SOP. From the results of research conducted by observing and reviewing documents, it can be concluded that procedures based on practice are more complete than existing SOPs related to the logistics management process of pharmaceutical supplies. However, the application of the SOP can also be said to be good, it's just that the SOP is too short so it doesn't contain the actual details.

Internal Control Analysis of Drug Inventory
By using the component analysis of internal inventory control according to the Committee of Sponsoring Organizations (COSO) (2013)  and refrigerators, using a perpetual inventory recording system, using an inventory valuation system, namely FEFO (First Expired First Out), stipulates the minimum expiration date for each ordered drug supply, which is at least 2 years, and organizes stock taking activities every 3 months.

• The Pharmacy Installation of Kardinah Tegal
Hospital has identified and analyzed every form of risk that may be experienced by looking at the potential risks that have been seen and will be seen. Control activities set by the Pharmacy Installation to minimize the risk of expiry of drug supplies that may occur by setting a minimum expiration date for each drug ordered, which is a minimum of approximately 2 years for each type of drug so that the occurrence of drug expiration can be suppressed, using a perpetual inventory recording system, namely every Incoming and outgoing goods will be recorded directly in detail on the stock card, and also using the inventory valuation system, namely FEFO (First Expired First Out).

(3) Control Activities
• The Hospital Pharmacy Installation has studied and understood every risk that may occur in the hospital by conducting risk identification and analysis so that the risk can be at a level that is acceptable to the hospital. The Pharmacy Installation has also carried out a division of authority between functions which is reflected in the organizational structure. The control activities built by the pharmaceutical installation are as follows: • Pharmacy installations use a perpetual inventory recording system where every entry and exit of drugs from the warehouse is always recorded in a stock card, besides that the recording has been done computerized.
• Pharmacy installations use an inventory assessment system, namely FEFO (First Expired First Out) as an effort to avoid the risk of expiry on drug supplies. • Pharmacy installations set a minimum expiration date for each drug ordered at least 2 years as an effort to avoid expiry of the drug supply by making a direct request during negotiations with PBF when placing an order. • Pharmacy installations carry out physical inventory counts every three months. Hospital communicates internally to support internal control. Communication The Head of IFRS conducts an evaluation to discuss the deficiencies that occur and coordination with employees has gone well.

• The Pharmacy Installation at Kardinah Tegal
Hospital communicates well externally to support internal control. Communicating with PBF or drug distributors to get the needed items. (5) Monitoring Activities • The Pharmacy Installation evaluates the performance of all employees during ongoing work or when work has been completed so that employees know what needs to be improved and improved. • Evaluation is carried out by all employees of the Pharmacy Installation and all parties communicate properly all the shortcomings they have so that the best solution can be found.
Following are the results of a review of the implementation of the internal control system at Kardinah Hospital Tegal with the Committee of Sponsoring Organizations (COSO):  (2022) Based on table 2 data, it is known that the internal control system in the Pharmacy Installation of Kardinah Tegal Hospital has implemented an internal control system as determined by COSO, this condition is indicated by the fulfillment of all the principles required by COSO on each control component.

Analysis of Factors Causing Scarcity of Drug Supplies
In principle, the inventory of goods in the warehouse should not exceed or experience a shortage. Inventory that must remain in accordance with the standards that have been calculated so that the inventory does not exceed the standard limits of goods. The initial process of stock out is when there is a request for an unserved patient. This can be caused because the requested item is available but in quantity it cannot meet the demand or the item is not available at all. Kardinah Hospital Tegal if the desired item is not available, the pharmacy department will try to negotiate with the user to be able to replace the drug with the same type but with a different Business Management and Accounting_Volume 2 Issue 1 (2022) "Strengthening Youth Potential for Sustainable Innovation" 42 trademark. If the negotiation is successful, the patient does not need to buy drugs from outside pharmacies, but if the negotiations are not successful, the patient will be advised to buy drugs from outside pharmacies.
The factor of running out of stock is not only seen from the budget and distributors, but also the existence of a tiered referral policy which causes the hospital to experience a decrease in revenue so that it still has outstanding debts in previous years. Another factor is that the user who plays an active role in the use of the formulary when prescribing does not know the condition of the drug supply in the Pharmacy Warehouse.
The internal factor of running out of stock of drugs that occurred at Kardinah Hospital Tegal was because the implementation of the use of the formulary by the user had not run optimally and the lack of budget due to debts that had not been paid. Meanwhile, the external factor is the occurrence of out of stock due to large pharmaceutical companies experiencing a shortage of raw materials for making drugs and delays in delivery so that they cannot fulfill the requested orders and the existence of a tiered referral policy which results in a decrease in revenue. After knowing the causes of stock outs and the obstacles in the implementation of each activity, the fulfillment of drug needs as desired, is expected to be realized optimally.
Based on the results of observations at the hospital, it was stated that the occurrence of stock outs at Kardinah Tegal Hospital could be caused by several things, including: (1) Out of stock at distributors.
(2) Delay in delivery of goods.
(3) Late payments to partners. (4) The available funds are insufficient. (5) The existence of government policies that harm the hospital.
In the event of a vacancy in the stock of drugs, it has also been regulated in the SOP of Kardinah Tegal Hospital regarding Cooperation of Pharmacy Installations with Hospitals or Pharmacies Regarding the Fulfillment of Empty Drugs for General Patients, in order to provide medicine for patients at Kardinah Tegal Hospital when the drug in question is not available at the pharmacy installation. with the aim of improving optimal prescription services for patients treated at Kardinah Hospital Tegal. With this policy, it is easier to serve patients if there is a stock out.

Drug Inventory Fraud Prevention Analysis
Kardinah Tegal Hospital on drug supply refers to the existing SOP on the Protection of Pharmaceutical Supplies from Loss or Theft which aims to monitor the safety of pharmaceutical supplies in all storage and distribution areas so that their safety can be guaranteed. Fraud prevention can also be analyzed from the existence of internal control elements according to Mulyadi (2016)  Internal control in the organizational structure is quite good in terms of the separation of the reception function and the procurement function. The authorization system that has been carried out is supported, it can be seen that each procedure will be authorized by the authorized official. The methods used by the Kardinah Tegal Hospital in creating healthy practices are good.

CONCLUSIONS AND RECOMMENDATION
The drug inventory accounting information system run by the Pharmacy Installation of Kardinah Tegal Hospital as a whole has been running well, the Pharmacy Hospital Management Information System (SIMRS) as a digital system has also been running effectively and efficiently to assist drug management activities starting from planning, procurement, receipt, distribution, and administration of invoice payments. Availability of SOPs on Logistics Management of Pharmaceutical Supplies, Out of Stock Handling Procedures which aim to improve optimal prescription services, as well as Procedures for the Protection of Pharmaceutical Supplies from Loss or Theft which aims to monitor the safety of pharmaceutical supplies in all storage and distribution areas in order to ensure their safety. However, in practice there is a discrepancy with the SOP, so it is recommended to revise the SOP.
Internal control at the Pharmacy Installation at Kardinah Tegal Hospital can be concluded that the Pharmacy Installation is in accordance with and has implemented internal control standards according to the Committee of Sponsoring Organization (COSO). The factors causing the scarcity of supply of medicines include vacancies at distributors, delays in delivery of goods, late payments to partners, and insufficient funds available. The authorization system that has been carried out is supported, it can be seen that each procedure will be authorized by the authorized official. The methods used by the Kardinah Tegal Hospital in creating healthy practices are already good. These things are done in order to minimize fraud in both inventory and organization.